by Dr. Iain Corness
Do you need insurance?
I have just renewed my medical
insurance, for myself, my wife and the children. Whilst I hate giving
anything away (my Scottish heritage comes forth at times when I have to open
the wallet), I have to say the premium was not expensive, and far less than
I would pay in the western world.
you haven’t upgraded your cover recently, then you may be in for a nasty
surprise. Unfortunately, everything, be that petrol, bread, or baby’s
nappies has gone up in price in the past 12 months. If you haven’t upgraded
there could be a shortfall, which you have to find (or fund), not your
I have also been
very lucky with my choice of careers. Being a medico does have advantages.
If I couldn’t fix my skin rash or whatever, I could always ring a classmate
who could (or should) be able to. Medications and drugs? Again no worries,
just a quick raid of the samples cupboard in my surgery and I had everything
I needed. Insurance not needed. (One of my medical friends used to say
that after diagnosing some condition in his family, he would go to his
samples cupboard. If he couldn’t find what he wanted, he would change the
diagnosis to use some medication he did have! True.)
What about hospital
in-patient insurance? I passed on that one too.
After all, the only foreseeable problems that could stop me working were
massive trauma following a road accident or suchlike, or a heart attack. In
either case you don’t care where you are as long as there are wall to wall
running doctors and plenty of pain killers. In Australia, the “free” public
hospital system is fine for that.
So I blithely
carried on through life insuranceless. I did spend one night in hospital
with a broken leg 30 years ago, so as regards personal medical costs versus
proposed insurance premiums, I was still miles in front.
And then I came to
Thailand. Still I blithely carried on, after all, I was ten foot tall and
bullet proof. Then a friend over here had a stroke and required
hospitalisation. Said friend was four years younger than me and I was
forced to review the ten foot bullet proof situation to find I was only five
foot eleven and my anti-kryptonite had expired. Thailand was a completely
Enquiries as to
hospital and medical costs showed that they were considerably less than the
equivalent in Oz, but, and here’s the big but, there’s no government system
or sickness benefits to fall back on. Suddenly you are walking the
tightrope and there’s no safety net to stop you hitting terra firma.
So I took out
medical insurance. Still it was no gold plated cover. But it was enough to
look after me if I needed hospitalisation, and that came sooner than I
imagined. I had always subscribed to the “major trauma” theory, but two
days of the galloping gut-rot had me flat on my back with the IV tube being
my only life-line to the world. We are only mortal - even us medicos.
Do you have medical
insurance? Perhaps it is time to chat to a reputable insurance agent! Yes,
reliable insurance agents and reliable insurance companies do exist, but you
need help through the minefield.
You also need help
when it comes to filling out the application forms, in my opinion. And you
also need to be 100 percent truthful. Yes, insurance companies will check
on your records, and if it is found that you have been sparing with the
truth over pre-existing conditions, expect a shock at settling up time at
the cashier’s desk.
Remember too, that just because you
have an insurance card does not automatically signify that ‘everything’ is
covered. This is why private hospitals will ask you for a deposit on
admission. If the insurance company later verifies that you are indeed
covered for that ailment or condition, then you’ll get it back, but you have
to prove that you are covered, not the other way round!
And remember to check out your
Cattle Class Syndrome and Aspirin
As the Xmas break approaches, many of you will be getting
ready to fly overseas (well, as long as you aren’t flying Qantas this
week). However, no matter what airline you choose, anybody who flies -
regularly or just the annual travelers, is in danger of getting the “Economy
Class Syndrome.” This is a condition that has become prevalent with the
advent of ‘long haul’ sectors, but fortunately, there are ways to prevent
this happening, so read on.
Getting right down to tin-tacks, the
Economy Class Syndrome is just a fancy title for a very common condition
called Deep Venous Thrombosis, or more simply, a blood clot in a deep vein
in the legs. We shorten this to DVT, because we doctors like acronyms, and
what’s more they easier to spell than the long names.
DVT’s occur not just in plane
passengers, but in hospitals in the post operative period. In fact, the
latest figures from Australia would indicate that 50 percent of people who
have orthopaedic surgery are likely to get a DVT. Even 20 percent of
general surgery patients are in line for this condition. These are not
large DVT’s I hasten to add, but are demonstrable in the blood, without
their producing clinical symptoms.
And all that gets me back to my daily
medication, prescribed for me by the new generation’s hope for salvation,
the young Dr. Jonathan Corness, a new breed medico, about whom I am very
proud - but I digress. Dr. Jonathan prescribed one of the oldest
medications in the world for me - Aspirin. So why would this
up-to-the-minute medico prescribe something as old hat as Aspirin? Quite
simply, because it works! (Which is not something I can say without
hesitation about some of the drugs available these days.)
In therapeutic doses to stop headaches
and relieve arthritis, we are looking at something between 300-600 mgms four
times a day for most people and Aspirin works well here. However, at that
dosage you run the risk of upsetting your stomach, to actual bleeding and
ulceration. There are also people who show allergic reactions to Aspirin,
from asthma right the way through to anaphylactic shock and death! Yes,
this is potent medicine.
However, there are other conditions for
which Aspirin is the drug of choice, and not in the big doses either. We
are talking here of 100 mgm doses taken once a day only. This way the
chances of allergy/asthma and gastric bleeding are greatly reduced. What
the Aspirin does is work on the aggregation of platelets. This is where the
red blood cells sort of form into clumps and these become clots and are the
start of the Deep Vein Thromboses (DVT’s). And this is what happens in the
Economy Class Syndrome, if you are unlucky.
Now medical science has found that by
taking 100 mgm of Aspirin daily you lower your chances of heart attack,
something much higher on my personal risk table than Economy Class
Syndrome. You see, clotting can occur in many areas of the body, and a clot
in the coronary arteries can be extremely life threatening. And life
shortening! And yet so easily avoided, with one little tablet every day.
You can buy baby Aspirin, but I used “Cardiprin” - this is more expensive,
but comes in a push-through calendar pack, which gets me to remember to take
it better than just a bottle of tablets on the breakfast table. However, if
it is your pocket you wish to look after, as well as your cardiovascular
system, then the 81 mg Baby Aspirin tablets will do the trick (just remember
to take one a day!)
Now getting back to flying, the secret
to health in the air is purely to maintain good circulation and avoid
dehydration. To maintain circulation to the lower legs you should get up
and walk around the plane once every hour. Choose an aisle seat so you can
get in and out easily. The relative dehydration is also easy to fix - drink
more water, not more alcohol! So on the hourly walk, stop at the kitchen
area and ask for a drink of water. That’s it! Simple. Have a great
Check-ups 50 percent off
I just had my own annual checkup last month, and I am
pleased to say that everything is looking good. The little extra weight I
had last year has gone, and the cholesterol has come down with it.
My annual medical check-up is an
important part of my planning for the future, a future with a good Quality
of Life. Check-ups are inherently involved in the Quality of Life.
Longevity alone, with no quality, just isn’t worth it in my book.
Many people work on the principle that
they would rather not know about any underlying or sinister medical
conditions they may have. After all, we are all going to die one day,
aren’t we? I have always said that despite all advances in medical science,
the death rate will always be the same - one per person! But wouldn’t you
rather have pleasant final years than one of poor health, infirmity and
aches and pains?
The guiding principle behind check-ups
is to find deviations from normal health patterns at an early stage. Early
enough that the trend can be reversed, before damage has occurred. Examples
of this include Blood Pressure (BP), as high BP can affect many organs in
the body, not just the heart. But an elevated BP generally gives no warning
Another example is blood sugar. Again,
it requires sky-high sugar levels before the person begins to feel that
something might be wrong. And by then the sugar levels have affected
vision, the vascular system and many other systems, all of which can
decrease your future Quality of Life. Amputation of a limb is a common
result of unchecked blood sugar levels.
Cardiac conditions and abnormalities,
be that in anatomy or function, can also very adversely affect your Quality
of Life, but are very easily found during a routine check-up. Various blood
tests and an EKG can show just how well the cardiac pump is functioning, and
how well it will continue to function in the future. The inability to walk
more than 50 meters certainly takes the fun out of shopping, yet this can be
predicted - if you have some serial records!
Another of the silent killers can be
discovered in your lipid profile, with Cholesterol and its fractions HDL and
LDL, being intimately connected with your cardiac status.
Let me give you an example. A younger
man who was obviously overweight, but played golf three times a week and had
no apparent problems. He enjoyed his golf, and the beers at the 19th hole.
Just like his overweight golfing mates.
This chap’s blood tests were not so
good, and his diabetic tendency was now more than just a tendency. Despite
the fact that he was not having chest pains, he decided to have the 64-Slice
CT of the coronary arteries carried out. This showed three blockages.
Three corrective stents later he could return to the golf course, but with
urgent recommendations to get his weight down and get his blood sugar and
cholesterol under control.
There are actually so many conditions
that can affect your enjoyment of the future that can be discovered early.
Renal (kidney) function and liver function can be monitored through an
annual check-up, as can prostate size (indicated by the PSA blood test) or
breast tumors (by mammogram).
Hopefully you are now thinking about an
annual check-up. Catch anything early and you have given yourself the chance
to correct it - and get a better Quality of Life in the forthcoming years.
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